Sundowning a symptom of dementia that can appear in the evening

Dr Hilary lists the early symptoms of dementia

Dementia is a group of symptoms related to the ongoing decline of the brain.

For this reason it can affect memory, behaviour and even movement.

Although there is no cure for dementia, there are treatments and support available to those who need it.

Therefore, it is vital any signs of dementia are addressed as soon as they are spotted.

According to the Alzheimer’s Society, some symptoms can appear towards the end of the day.

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Known as “sundowning”, the affected person could become distressed or agitated.

The charity explains: “Sometimes you might see changes in the person’s behaviour in the later afternoon or towards the end of the day.

“During this time the person may become intensely distressed, agitated and have hallucinations or delusions.

“This may continue into the night, making it hard for them to get enough sleep.

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“This is sometimes known as ‘sundowning’ but is not necessarily linked to the sun setting or limited to the end of the day.

“Sundowning can happen at any stage of dementia but is more common during the middle stage and later stages.”

Causes of sundowning

Sundowning can be triggered by a number of factors.

Dementia UK says: “As the day goes on, the person with dementia becomes more tired, and this can lead to their dementia symptoms worsening.

“Hunger, thirst and physical pain can also play a part.

“As darkness falls, streetlights come on and people settle in for the evening.

“These changes can make the person increasingly concerned that they are in the wrong place, or that they have forgotten to do something vital during the day.”

The Alzheimer’s Society lists the following as causes of sundowning:

• Tiredness, hunger, pain or other unmet physical needs
• Not enough exposure to sunlight during the day
• Overstimulation during the day, such as from a noisy or busy environment
• Disturbance to the person’s ‘body clock’ caused by damage to the brain
• Disturbed levels of hormones that vary over the course of the day
• Sensory impairment, such as hearing or sight loss
• Tiredness in other people causing the person with dementia to become upset
• Mood disorders, such as anxiety or depression
• Fewer carers around to look after the person (in a care home)
• Side effects of prescribed drugs.

What to do if you think someone is showing signs of sundowning?

If you think someone is showing signs of sundowning but is undiagnosed with dementia you should seek medical help.

To manage the symptoms Dementia UK recommends:

• Using distraction techniques: go into a different room, make the person a drink, have a snack, turn some music on, or go out for a walk
• Asking them what the matter is. Listen carefully to their response and if possible, see if you can deal with the reason for their distress
• Talking in a slow, soothing way
• Speaking in short sentences and give simple instructions to try to avoid confusion
• Holding the person’s hand or sitting close to them and stroking their arm.

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